Wheelchair provision - short-term loans: guidance

Appendix A

Equipu Partnership Provision of wheelchairs for short term use – Criteria and assessment check list

Service user's name
CHI number
Address
Contact details

This service will only provide a wheelchair and no other services e.g. environmental adaptations/ramps etc. Chairs cannot be adapted or accessorised and come as per the specification below.

Alternatives such as long term specialised wheelchairs for those with complex seating requirements and for those who spend considerable time in their wheelchair are sourced via appropriate referral to Westmarc wheelchair service.

Loan period is for a maximum of 6 months or less

The criteria for provision are: -

Temporary use post-operatively to facilitate hospital discharge/ prevent admission
For improved quality of 'end of life' care.

Wheelchairs for short term loan within the Equipu Partnership have the following specifications:-

• attendant propelled folding wheelchair
• Seat Width: 19"
• Weight: 14.9kg
• Maximum user limit - 125kg/19st
• Half folding back
• Removable armrests for side transfers and access swing in/out leg rest hangers
• Flip up adjustable height footplates.
• Anti-tippers for extra stability on slopes or uneven ground
• Foot operated attendant controlled brakes Lap strap

Considerations for the service user prior to use

1. The wheelchair is suitable for the environment- there is access for transfers or space to manoeuvre. Can the wheels cope with very uneven ground if this is encountered?

2. The chair fits the service user's dimensions and they are within the safe weight limit for the wheelchair.

3. How much assistance does the user need to get into the chair, and can the attendant cope with this?

4. The service user has adequate sitting balance to sit in the chair without risk of falling out.

5. The foot rests are adequate to support the user's legs and feet without risk of them falling off and being dragged under the chair.

6. Will the user be able to cope with the vibration when ground is uneven [pain; maintaining position etc.]

7. Are there any basic requirements for pressure care/cushions?

Service users with unpredictable behaviour can be at risk in a wheelchair so ensure that:-

1. The service user will keep their feet on the footplates when the chair is in motion

2. The service will not try to get out of the chair while it is in motion.

The attendant must: -

1. Have the capacity to push the chair n.b. a gentle slope can be difficult to negotiate even with a light passenger

2. Use the chair safely and appropriately – operate the brakes, reach the footplates to apply them, tip the chair to cope with steps and uneven surfaces?

3. Be able to fold up the chair and lift into vehicles if required?

Have the service user and/or attendant been given adequate instruction in the use of the chair?

Yes
No

[See wheelchair equipment template below for further information]

Assessor
Date
Assessors signature
Planned date of uplift:-